Abstract
The diagnosis of various pathomorphological forms of acute appendicitis (AA), acute mesadenitis (AM), and abdominal tuberculosis (AT) remains an urgent problem in medicine. Neutrophilic granulocytes are the first link in the nonspecific immune response to inflammation, which is mediated by phagocytosis and intracellular bactericidal systems. Therefore, the research aimed to establish the features of the functional state of neutrophilic granulocytes in the blood of patients with AA, AM, and AT.Materials and methods. 30 practically healthy, 27 patients with AM, 40 patients with acute phlegmonous appendicitis were examined; 20 patients with acute gangrenous appendicitis, 30 patients with AT. The phagocytic activity of neutrophils in the test with latex granules, redox activity (spontaneous HCT test), cationic lysosomal proteins in the cytochemical test with bromine phenol blue was determined in the blood.Results. Phagocytic activity of neutrophils in patients with destructive forms of AA and AT was lower, and in the group of patients with AM – did not differ from control values. The phagocytic index of neutrophils in patients with destructive forms of AA was 1.5 times lower (p<0.05), and the phagocytic number in patients with gangrenous AA was 1.7 times lower than in healthy individuals (p<0.05). In patients with AM, the percentage of HCT-positive neutrophils was 1.3 times higher, in patients with destructive forms of AA and AT – 2 times higher than in healthy groups (p<0.05). The number of neutrophils containing cationic lysosomal proteins was also higher in destructive forms of AA, and in AM and AT - did not differ from the value in the control group.Conclusions. It has been established that peripheral blood neutrophils in conditions of acute destructive inflammation and abdominal tuberculosis have reduced absorption capacity with simultaneous significant activation of redox processes. Cytochemical tests to detect the phagocytic and metabolic activity of blood neutrophils are available and highly informative for the diagnosis and prediction of inflammation, as well as for the differential diagnosis of bacterial and viral diseases
Highlights
Abdominal pain is the most common reason for seeking medical attention [1]
The aim of the study was to establish the features of the functional state of neutrophilic granulocytes in the blood of patients with acute appendicitis and abdominal tuberculosis
The group of patients with acute mesadenitis (AM) consisted of 27 people, whose average age was 32.1±1.56 years; patients with acute phlegmonous appendicitis (APA) – 40 people; on acute gangrenous appendicitis (AGA) – 20 people
Summary
Abdominal pain is the most common reason for seeking medical attention [1]. Among the inflammatory diseases of the abdominal organs (AO), which are accompanied by acute abdominal pain, the most common are gallstone disease and acute appendicitis (AA). The problem of differential diagnosis of abdominal diseases of chronic nature (abdominal tuberculosis), acute nonspecific mesenteric lymphadenitis (AM), which can be treated conservatively, with acute destructive appendicitis that requires surgery. In the immune response cascade, neutrophilic granulocytes are the first link in the nonspecific inflammatory response [5]. Their main function is the intracellular killing of foreign objects – phagocytosis. And correct assessment of the functional state of the effector link of nonspecific immune defence in the conditions of urgent surgical pathology is one of the important criteria for choosing or modifying treatment tactics [8, 9]. The functional activity of neutrophilic granulocytes is determined by the absorption capacity, the activity of redox processes and the content of cationic lysosomal proteins [10]
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